Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $172.12 / $692.49 / $1,798.66	Facility		$172.12	$692.49	$1,798.66
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.19 / $24.20 / $35.56	Facility	26	$24.19	$24.20	$35.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.82 / $138.90 / $239.31	Professional		$113.82	$138.90	$239.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.44 / $24.19 / $74.26	Professional	26	$18.44	$24.19	$74.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.13 / $117.11 / $189.87	Professional	TC	$99.13	$117.11	$189.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.13 / $151.13 / $151.13	Professional		$151.13	$151.13	$151.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.70 / $22.70 / $23.53	Professional	26	$22.70	$22.70	$23.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.44 / $128.44 / $128.44	Professional	TC	$128.44	$128.44	$128.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.80 / $264.83 / $425.44	Facility		$115.80	$264.83	$425.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.35 / $26.35 / $26.35	Facility	26	$26.35	$26.35	$26.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.88 / $225.81 / $362.68	Professional		$156.88	$225.81	$362.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.38 / $31.59 / $52.13	Professional	26	$22.38	$31.59	$52.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.21 / $194.06 / $310.24	Professional	TC	$134.21	$194.06	$310.24
Denver HMP Facility/Professional Facility Modifier Low / Median / High Price $137.93 / $190.13 / $291.95	Facility		$137.93	$190.13	$291.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $167.05 / $205.81 / $294.01	Professional		$167.05	$205.81	$294.01
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.25 / $33.57 / $47.96	Professional	26	$27.25	$33.57	$47.96
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $139.80 / $172.23 / $246.05	Professional	TC	$139.80	$172.23	$246.05
United Facility/Professional Professional Modifier Low / Median / High Price $170.72 / $255.54 / $369.60	Professional		$170.72	$255.54	$369.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.90 / $34.50 / $53.78	Professional	26	$24.90	$34.50	$53.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.44 / $217.37 / $301.75	Professional	TC	$138.44	$217.37	$301.75